March 13, 2012

Providers’ Attitude Toward Vaccinating Young Males Against HPV May Challenge New Recommendations

by editor

Researchers from Boston University School of Medicine (BUSM) have found that a health care provider's attitude toward male human papillomavirus (HPV) vaccination may influence the implementation of new guidelines. They believe targeted provider education on the benefits of HPV vaccination for male patients, specifically the association of HPV with certain cancers in men, may be important for achieving vaccination goals. These findings appear on-line in the American Journal of Men's Health.

HPV infects approximately 20 million men and women in the United States each year. It can cause anal, penile and oropharyngeal cancers in men. Approximately 7,000 HPV-associated cancers are diagnosed in men annually. Last year, the Advisory Committee on Immunization Practices issued a revised statement recommending universal vaccination of 11- to 12-year-old males with catch-up vaccinations for males age13 to 21. The revised, stronger recommendation came in response to new data showing that vaccination could effectively prevent both genital warts and anal cancer precursors and epidemiologic data showing the increasing importance of HPV as a causal factor for head and neck cancers.

Between 2009 and 2010 BUSM researchers assessed pediatric and family medicine providers' attitudes and behaviors around HPV vaccinations. The providers included 23 physicians and eight nurse practitioners from four community health centers in the Boston area that serve primarily low-income, minority and non-English-speaking populations. Although 24 of 31 (77 percent) of the providers favored vaccinating males, only three (12 percent) offered vaccination. Providers who did not offer vaccination felt that parents would not be interested in vaccinating sons to prevent cervical cancer in women and were largely unaware of serious HPV-related disease in males.

"Although we believe the new recommendations will likely cause some improvement in HPV vaccination levels for males, their adoption may remain slow if physicians are unaware of the rationale behind the strengthened recommendations," explained lead author Rebecca B. Perkins, MD, MSc., assistant professor of Obstetrics and Gynecology at BUSM.

According to Perkins, in light of the new recommendations promoting universal HPV vaccination for males, understanding provider attitudes and actions with regard to this vaccine gains increasing importance. "Although prior research indicated that most physicians supported HPV vaccination for males, research with both parents and providers raised concerns that parents may be more reluctant to vaccinate sons than daughters," she added.